单绒毛膜双羊膜囊性双胎妊娠临床分析  

Clinical analysis of 765 cases of monochorionic double amniotic cystic twin pregnancy

作　　者：张敬如[1] 张国华[1] 赵霞[1] 袁丽娟 高丽红[1] 王亚男[1] ZHANG Jingru;ZHANG Guohua;ZHAO Xia(Department of Obstetrics,The Fourth Hospital of Shijiazhuang City,Hebei,Shijiazhuang 050011,China)

机构地区：[1]河北省石家庄市第四医院产三科

出　　处：《河北医药》2020年第2期279-281,285,共4页Hebei Medical Journal

基　　金：河北省医学科学研究重点课题计划(编号:20191431)

摘　　要：目的探讨单绒毛膜双羊膜囊性双胎的孕期并发症及妊娠结局。方法收集2013至2017年收治的765例单绒毛膜双羊膜囊性双胎患者作为观察组,同期收治的2655例双绒毛膜性双胎作为对照组。所有患者均经彩色多普勒超声及产后病理确认绒毛膜性质。比较2组孕产妇孕期并发症、分娩孕周及围产儿妊娠临床结局,进一步探讨单绒毛膜性对母婴的影响。结果观察组与对照组妊娠期高血压疾病发生率比较,差异无统计学意义(P>0.05),对照组妊娠期糖尿病发生率高于观察组,差异有统计学意义(P<0.05),单绒毛膜组剖宫产率、早产率、低出生体重儿、死胎率、围产儿病死率明显高于双绒毛膜组,差异均有统计学意义(P<0.05)。结论单绒毛膜双羊膜囊性双胎妊娠其胎儿不良结局发生率较高,孕早期超声确定双胎妊娠绒毛膜性至关重要,尽早而准确的诊断以及因人而异的个体化治疗方案选择对改善妊娠结局、降低围产儿发病率和病死率具有重要意义。Objective To investigate the pregnancy complications and pregnancy outcome of monochorionic double amniotic cystic twins.Methods A total of 765 patients with monochorionic double amniotic cystic twins who were admitted and treated in our hospital from January 2013 to December 2017 were enrolled as observation group,at the same time,the other 2655 patients with double chorionic twins were enrolled as control group.All the patients underwent color Doppler ultrasound and postpartum pathology to confirm the chorionic properties.The complications during pregnancy,the gestational weeks of delivery and the clinical outcome of perinatal pregnancy were observed and compared between the two groups.Results There was no significant difference in the incidence rate of hypertensive disorder between the two groups(P>0.05),however,the incidence rate of gestational diabetes in control group was significantly higher than that in observation group(P<0.05).Moreover the cesarean section rate,premature rate,low birth weight infants,stillbirth rate,and perinatal mortality in monochorionic membrane group were significantly higher than those in double chorionic membrane group(P<0.05).Conclusion Monochorionic double amniotic cystic twin pregnancy has higher incidence rate of fetus adverse outcomes,therefor,it is important to determine the chorionicity of twin pregnancy by ultrasound examination at early period of pregnancy,and to make the individualized treatment options according to different condition,so as to improve pregnancy outcome and reduce perinatal morbidity and mortality.

关 键 词：双胎妊娠 绒毛膜性 围产儿结局 

分 类 号：R714.2[医药卫生—妇产科学]